Melaena as the presenting symptom of gastric mucosal injury due to blunt abdominal trauma

Blunt abdominal trauma is a common cause of admission to the typical trauma centre. Hollow viscus injury from blunt trauma, however, is unusual and rarely involves the stomach. A 15 year old boy sustained a bicycle handle bar injury to the abdomen and presented to the casualty department four days l...

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Bibliographic Details
Published in:Emergency medicine journal : EMJ 2006-05, Vol.23 (5), p.e34-e34
Main Authors: Saeb-Parsy, K, Omer, A, Hall, N R
Format: Article
Language:English
Subjects:
Abdomen
Abdominal Injuries - complications
Adolescent
Bicycling - injuries
blunt abdominal trauma
Case Report
Endoscopy
Endoscopy, Gastrointestinal
Gastric Mucosa - injuries
gastric ulceration
Humans
Injuries
Male
melaena
Melena - etiology
Mortality
Mucous membrane
Patients
Pyloric Antrum - injuries
Stomach
Trauma
Wounds, Nonpenetrating - complications
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Summary:Blunt abdominal trauma is a common cause of admission to the typical trauma centre. Hollow viscus injury from blunt trauma, however, is unusual and rarely involves the stomach. A 15 year old boy sustained a bicycle handle bar injury to the abdomen and presented to the casualty department four days later with melaena. A computed tomography (CT) scan of the abdomen showed normal findings but endoscopy revealed two “kissing” areas of mucosal ulceration on the anterior and posterior wall of the gastric antrum. The patient received a blood transfusion for anaemia but was otherwise treated conservatively and made a full recovery. The authors believe this to be the first reported case of melaena as the primary presenting symptom of gastric ulceration secondary to blunt abdominal trauma. Diagnosis of hollow viscus injuries due to blunt abdominal trauma requires a high index of suspicion and thorough investigation, particularly if the presentation is delayed.
ISSN:1472-0205
1472-0213
DOI:10.1136/emj.2005.033621